[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1257 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                S. 1257

   To establish grant programs to improve the health of border area 
residents and for all hazards preparedness in the border area including 
      bioterrorism and infectious disease, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 22, 2011

Mr. Bingaman (for himself and Mrs. Hutchison) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To establish grant programs to improve the health of border area 
residents and for all hazards preparedness in the border area including 
      bioterrorism and infectious disease, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Border Health Security Act of 
2011''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The United States-Mexico border is an interdependent 
        and dynamic region of 14,538,209 people with significant and 
        unique public health challenges.
            (2) These challenges include low rates of health insurance 
        coverage, poor access to health care services, and high rates 
        of dangerous diseases, such as tuberculosis, diabetes, and 
        obesity.
            (3) As the 2009 novel influenza A (H1N1) outbreak 
        illustrates, diseases do not respect international boundaries, 
        therefore, a strong public health effort at and along the U.S.-
        Mexico border is crucial to not only protect and improve the 
        health of Americans but also to help secure the country against 
        biosecurity threats.
            (4) For 11 years, the United States-Mexico Border Health 
        Commission has served as a crucial bi-national institution to 
        address these unique and truly cross-border health issues.
            (5) Two initiatives resulting from the United States-Mexico 
        Border Health Commission's work speak to the importance of an 
        infrastructure that facilitates cross-border communication at 
        the ground level. First, the Early Warning Infectious Disease 
        Surveillance (EWIDS), started in 2004, surveys infectious 
        diseases passing among border States allowing for early 
        detection and intervention. Second, the Ventanillas de Salud 
        program, allows Mexican consulates, in collaboration with 
        United States nonprofit health organizations, to provide 
        information and education to Mexican citizens living and 
        working in the United States through a combination of Mexican 
        state funds and private grants. This program reaches an 
        estimated 1,500,000 people in the United States.
            (6) As the United States-Mexico Border Health Commission 
        enters its second decade, and as these issues grow in number 
        and complexity, the Commission requires additional resources 
        and modifications which will allow it to provide stronger 
        leadership to optimize health and quality of life along the 
        United States-Mexico border.

SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMISSION ACT AMENDMENTS.

    The United States-Mexico Border Health Commission Act (22 U.S.C. 
290n et seq.) is amended--
            (1) in section 3--
                    (A) in paragraph (1), by striking ``and'' at the 
                end;
                    (B) in paragraph (2), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following:
            ``(3) to serve as an independent and objective body to both 
        recommend and implement initiatives that solve border health 
        issues'';
            (2) in section 5--
                    (A) in subsection (b), by striking ``should be the 
                leader'' and inserting ``shall be the Chair''; and
                    (B) by adding at the end the following:
    ``(d) Providing Advice and Recommendations to Congress.--A member 
of the Commission may at any time provide advice or recommendations to 
Congress concerning issues that are considered by the Commission. Such 
advice or recommendations may be provided whether or not a request for 
such is made by a member of Congress and regardless of whether the 
member or individual is authorized to provide such advice or 
recommendations by the Commission or any other Federal official.'';
            (3) by redesignating section 8 as section 13;
            (4) by striking section 7 and inserting the following:

``SEC. 7. BORDER HEALTH GRANTS.

    ``(a) Eligible Entity Defined.--In this section, the term `eligible 
entity' means a State, public institution of higher education, local 
government, Indian tribe, tribal organization, urban Indian 
organization, nonprofit health organization, trauma center, or 
community health center receiving assistance under section 330 of the 
Public Health Service Act (42 U.S.C. 254b), that is located in the 
border area.
    ``(b) Authorization.--From amounts appropriated under section 12, 
the Secretary, acting through the Commissioners, shall award grants to 
eligible entities to address priorities and recommendations outlined by 
the Commission's Strategic and Operational Plans, as authorized under 
section 9, to improve the health of border area residents.
    ``(c) Application.--An eligible entity that desires a grant under 
subsection (b) shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may require.
    ``(d) Use of Funds.--An eligible entity that receives a grant under 
subsection (b) shall use the grant funds for--
            ``(1) programs relating to--
                    ``(A) maternal and child health;
                    ``(B) primary care and preventative health;
                    ``(C) infectious disease testing and monitoring;
                    ``(D) public health and public health 
                infrastructure;
                    ``(E) health promotion;
                    ``(F) oral health;
                    ``(G) behavioral and mental health;
                    ``(H) substance abuse;
                    ``(I) health conditions that have a high prevalence 
                in the border area;
                    ``(J) medical and health services research;
                    ``(K) workforce training and development;
                    ``(L) community health workers or promotoras;
                    ``(M) health care infrastructure problems in the 
                border area (including planning and construction 
                grants);
                    ``(N) health disparities in the border area;
                    ``(O) environmental health;
                    ``(P) health education;
                    ``(Q) outreach and enrollment services with respect 
                to Federal programs (including programs authorized 
                under titles XIX and XXI of the Social Security Act (42 
                U.S.C. 1396 and 1397aa));
                    ``(R) trauma care;
                    ``(S) health research with an emphasis on 
                infectious disease;
                    ``(T) epidemiology and health research;
                    ``(U) cross-border health surveillance coordinated 
                with Mexican Health Authorities;
                    ``(V) obesity, particularly childhood obesity;
                    ``(W) crisis communication, domestic violence, 
                substance abuse, health literacy, and cancer; or
                    ``(X) community-based participatory research on 
                border health issues; or
            ``(2) other programs determined appropriate by the 
        Secretary.
    ``(e) Supplement, Not Supplant.--Amounts provided to an eligible 
entity awarded a grant under subsection (b) shall be used to supplement 
and not supplant other funds available to the eligible entity to carry 
out the activities described in subsection (d).

``SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DISEASE SURVEILLANCE 
              (EWIDS) PROJECTS IN THE BORDER AREA.

    ``(a) Eligible Entity Defined.--In this section, the term `eligible 
entity' means a State, local government, Indian tribe, tribal 
organization, urban Indian organization, trauma centers, regional 
trauma center coordinating entity, or public health entity.
    ``(b) Authorization.--From funds appropriated under section 12, the 
Secretary shall award grants under the Early Warning Infectious Disease 
Surveillance (EWIDS) project to eligible entities for infectious 
disease surveillance activities in the border area.
    ``(c) Application.--An eligible entity that desires a grant under 
this section shall submit an application to the Secretary at such time, 
in such manner, and containing such information as the Secretary may 
require.
    ``(d) Uses of Funds.--An eligible entity that receives a grant 
under subsection (b) shall use the grant funds to, in coordination with 
State and local all hazards programs--
            ``(1) develop and implement infectious disease surveillance 
        plans and readiness assessments and purchase items necessary 
        for such plans;
            ``(2) coordinate infectious disease surveillance planning 
        in the region with appropriate United States-based agencies and 
        organizations as well as appropriate authorities in Mexico or 
        Canada;
            ``(3) improve infrastructure, including surge capacity, 
        syndromic surveillance, laboratory capacity, and isolation/
        decontamination capacity;
            ``(4) create a health alert network, including risk 
        communication and information dissemination;
            ``(5) educate and train clinicians, epidemiologists, 
        laboratories, and emergency personnel;
            ``(6) implement electronic data systems to coordinate the 
        triage, transportation, and treatment of multi-casualty 
        incident victims;
            ``(7) provide infectious disease testing in the border 
        area; and
            ``(8) carry out such other activities identified by the 
        Secretary, the United States-Mexico Border Health Commission, 
        State and local public health offices, and border health 
        offices at the United States-Mexico or United States-Canada 
        borders.

``SEC. 9. PLANS, REPORTS, AUDITS, AND BY-LAWS.

    ``(a) Strategic Plan.--
            ``(1) In general.--Not later than 5 years after the date of 
        enactment of this section, and every 5 years thereafter, the 
        Commission (including the participation of members of both the 
        United States and Mexican sections) shall prepare a binational 
        strategic plan to guide the operations of the Commission and 
        submit such plan to the Secretary and Congress (and the Mexican 
        legislature).
            ``(2) Requirements.--The binational strategic plan under 
        paragraph (1) shall include--
                    ``(A) health-related priority areas determined most 
                important by the full membership of the Commission;
                    ``(B) recommendations for goals, objectives, 
                strategies and actions designed to address such 
                priority areas; and
                    ``(C) a proposed evaluation framework with output 
                and outcome indicators appropriate to gauge progress 
                toward meeting the objectives and priorities of the 
                Commission.
    ``(b) Work Plan.--Not later than January 1, 2012, and every other 
January 1 thereafter, the Commission shall develop and approve an 
operational work plan and budget based on the strategic plan under 
subsection (a). At the end of each such work plan cycle, the Government 
Accountability Office shall conduct an evaluation of the activities 
conducted by the Commission based on output and outcome indicators 
included in the strategic plan. The evaluation shall include a request 
for written evaluations from the commissioners about barriers and 
facilitators to executing successfully the Commission work plan.
    ``(c) Biannual Reporting.--The Commission shall issue a biannual 
report to the Secretary which provides independent policy 
recommendations related to border health issues. Not later than 3 
months following receipt of each such biannual report, the Secretary 
shall provide the report and any studies or other material produced 
independently by the Commission to Congress.
    ``(d) Audits.--The Secretary shall annually prepare an audited 
financial report to account for all appropriated assets expended by the 
Commission to address both the strategic and operational work plans for 
the year involved.
    ``(e) By-Laws.--Not less than 6 months after the date of enactment 
of this section, the Commission shall develop and approve bylaws to 
provide fully for compliance with the requirements of this section.
    ``(f) Transmittal to Congress.--The Commission shall submit copies 
of the work plan and by-laws to Congress. The Government Accountability 
Office shall submit a copy of the evaluation to Congress.

``SEC. 10. BINATIONAL HEALTH INFRASTRUCTURE AND HEALTH INSURANCE.

    ``(a) In General.--The Secretary shall enter into a contract with 
the Institute of Medicine for the conduct of a study concerning 
binational health infrastructure (including trauma and emergency care) 
and health insurance efforts. In conducting such study, the Institute 
shall solicit input from border health experts and health insurance 
issuers.
    ``(b) Report.--Not later than 1 year after the date on which the 
Secretary enters into the contract under subsection (a), the Institute 
of Medicine shall submit to the Secretary and the appropriate 
committees of Congress a report concerning the study conducted under 
such contract. Such report shall include the recommendations of the 
Institute on ways to establish, expand, or improve binational health 
infrastructure and health insurance efforts.

``SEC. 11. COORDINATION.

    ``(a) In General.--To the extent practicable and appropriate, 
plans, systems and activities to be funded (or supported) under this 
Act for all hazard preparedness, and general border health, should be 
coordinated with Federal, State, and local authorities in Mexico and 
the United States.
    ``(b) Coordination of Health Services and Surveillance.--The 
Secretary may coordinate with the Secretary of Homeland Security in 
establishing a health alert system that--
            ``(1) alerts clinicians and public health officials of 
        emerging disease clusters and syndromes along the border area; 
        and
            ``(2) is alerted to signs of health threats, disasters of 
        mass scale, or bioterrorism along the border area.

``SEC. 12. AUTHORIZATION OF APPROPRIATIONS.

    ``There is authorized to be appropriated to carry out this Act 
$31,000,000 for fiscal year 2012 and each succeeding year subject to 
the availability of appropriations for such purpose. Of the amount 
appropriated for each fiscal year, at least $1,000,000 shall be made 
available to fund operationally feasible functions and activities with 
respect to Mexico. The remaining funds shall be allocated for the 
administration of United States activities under this Act, border 
health activities under cooperative agreements with the border health 
offices of the States of California, Arizona, New Mexico, and Texas, 
the border health and EWIDS grant programs, and the Institute of 
Medicine and Government Accountability Office reports.''; and
            (5) in section 13 (as so redesignated)--
                    (A) by redesignating paragraphs (3) and (4) as 
                paragraphs (4) and (5), respectively; and
                    (B) by inserting after paragraph (2), the 
                following:
            ``(3) Indians; indian tribe; tribal organization; urban 
        indian organization.--The terms `Indian', `Indian tribe', 
        `tribal organization', and `urban Indian organization' have the 
        meanings given such terms in section 4 of the Indian Health 
        Care Improvement Act (25 U.S.C. 1603).''.
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